Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Anesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe pre-eclampsia.
To describe the anesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe pre-eclampsia. ⋯ Hypoplastic anemia is rare in pregnancy but it poses an increased risk for both mother and fetus. The mother is at risk of life-threatening episodes of bleeding and infection and a multidisciplinary team approach (obstetrician, anesthesiologist, hematologist and pediatrician) is essential. An accurate assessment of the hematological condition should be made and abnormalities corrected before surgery. Regional anesthesia may not be possible in this circumstance.
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To report a preliminary analysis of prospectively recorded data in 27 children in whom patient-controlled regional analgesia (PCRA) was used for postoperative pain control following lower limb surgery. ⋯ Our preliminary observations indicate that PCRA in children provides satisfactory postoperative pain relief following lower limb surgery.
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Comparative Study
Posterior tibial nerve and median nerve somatosensory evoked potential monitoring during carotid endarterectomy.
Somatosensory evoked potential (SSEP) monitoring using the median nerve (MN) modality during carotid endarterectomy is well established. This study assessed the usefulness of monitoring the posterior tibial nerve (PTN) SSEP as an adjunct to MNSSEP for detection of cerebral ischemia and as an indicator for the insertion of a shunt in patients undergoing a carotid endarterectomy. ⋯ Monitoring of PTNSSEP is feasible and may be considered for an adjunct to MNSSEP or as an alternative modality if there are difficulties with MNSSEP. However, there may be a greater incidence of poor quality baseline tracings for PTNSSEP.
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Propofol is thought to act on gamma-aminobutyric acid receptors, which have some role in pain transmission in the spinal cord. In this study, we examined the effects of intrathecal propofol on acute thermally- or inflammation-induced pain in rats. ⋯ Intrathecal administration of propofol had analgesic effects on inflammation-induced acute and facilitated pain but not on thermally-induced acute pain. Transient motor and sensory disturbance could not rule out the possibility of neurotoxicity.